Organization
ON ANGEL'S WINGS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBRA QUIROZ (OFFICE DIRECTOR)
(623) 780-5690
Entity
Organization
Contact information
Practice address
23015 N 15TH AVE, STE 101, PHOENIX, AZ 85027-1323
(623) 780-5690
(623) 780-5692
Mailing address
23015 N 15TH AVE, STE 101, PHOENIX, AZ 85027-1323
(623) 780-5690
(623) 780-5692
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
786824
AZ
253Z00000X
In Home Supportive Care Agency
Primary
786824
AZ
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
786824
AZ
343900000X
Non-emergency Medical Transport (VAN)
786824
AZ
385H00000X
Respite Care
786824
AZ
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
786824
AZ
Other
Enumeration date
11/08/2012
Last updated
11/08/2012
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